a blog of books every doctor should read

Outliers: The Story of Success

Synopsis

In this, probably his most important book, Malcolm Gladwell explores the key factors that predict success. The author identifies the distinguishing features of all highly successful people, the so-called outliers: ‘…geniuses, business tycoons, rock stars, and software programmers‘ who ‘do things that are out of the ordinary’ (page 17). The author believes that ‘it is only by asking where they are from that we can unravel the logic behind who succeeds and who doesn’t’ (page 19). His beautifully woven anecdotes covered diverse fields including aviation, law, sports, education, and healthcare.

The book’s key argument is that opportunity is the key to success, and the author shows how successful people are ‘invariably beneficiaries of hidden advantages and extraordinary opportunities and cultural legacies‘, and these advantages ‘allow them to learn and work hard and make sense of the world in ways others cannot’ (page 19). Citing numerous examples, the book illustrated how success and failure are determined by circumstances rather than by any innate characteristics. These examples include the computer pioneers Bill Joy and Bill Gates who, by sheer chance, had unrestricted opportunities to hone the skills which made them successful (page 54). The author asserts that ‘successful people ….are products of particular places and environments‘ (page 119).

The major part of the book addresses the characteristic opportunities which give rise to success, and these are ‘coming from the right place’, and ‘being at the right time’. The author says ‘our ability to succeed at what we do is powerfully bound up with where we are from’ (page 209). He illustrated this with many examples such as the extraordinary number of American billionaires born in the 1930’s (page 62), the success of Jewish lawyers who practiced takeover law (page 120), and the disproportionate number Canadian professional hockey players born between the months of January to March (page 22). This form of demographic luck also works negatively as the author shows how Americans born before 1911 were disadvantaged because they were hit with ‘the most devastating events of the twentieth century’ (page 132). He concluded that ‘outliers are those who have been given opportunities-and who have had the strength and presence of mind to seize them’ (page 267). Paradoxically, ‘the outlier, in the end, is not an outlier at all’ (page 285).

The author, a journalist, illustrated his arguments with a variety of gripping and inspiring stories. These included the forensic analysis of the poor safety record of Korean Air (page 194-195), the demanding schedule of The Beatles in Hamburg nightclubs before they became famous (page 48), and Roseto, the outlier town where the inhabitants seemed to be immune from heart attacks and other diseases (page 7). He explored the sad story of Christopher Langam, the genius who could not translate his high IQ to real world success, contrasting his situation to that of Robert Oppenheimer who ‘possessed the kind of savvy that allowed him to get what he wanted from the world’ (pages 99-100).

The author referred to a large number of experts and concepts to support his arguments. These include Geert Hofstede on the dimensions of culture and the power distance index (pages 202-205); the economists Kelly Bedard and Elizabeth Dhuey on the influence of month of birth on mathematical skills (pages 28); K Anders Ericsson on expertise (page 39); Lewis Terman on the longitudinal study of gifted children (page 73); and Dov Cohen and Richard Nisbett on social inheritance and the Appalachian culture of honour (page 166). The key sociological and psychological concepts he discussed include the Matthew effect (page 30); the 10,000 hour rule (page 35), and the dangers of speech mitigation (page 194-195). The book reviewed human factors such as teamwork, communication, and decision making (pages 184-188); and the qualities which determine fulfilling work such as autonomy, complexity, and a connection between effort and reward (pages 149-150).

Opinion

The subject of success is relevant to all spheres of life, and the book brilliantly explores this. The authors writing style is almost unique in the way it flawlessly illustrates his arguments. His story telling is intricate, often weaving two or three stories together, never losing track of the subject matter. The book is characterised by rigorous and painstaking analysis, and it is clearly a well-researched work.

Overall assessment

The book has comprehensively treated this important topic. The authors highly logical reasoning and incisive analysis are appealing. I was impressed by his definition of fulfilling work, his exploration of safety issues, and his treatment of expertise. All these are relevant to healthcare and I highly recommend the book to all doctors.